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NPI Code Detail

MEDICARE: DR. JASON BRIAN WASSERMAN M.D.

MEDICARE:  DR. JASON BRIAN WASSERMAN  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207YX0007XPlastic Surgery within the Head & Neck (Otolaryngology) Physician284195-1NY
2207Y00000XOtolaryngology Physician284195NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1284195OTHERNYLICENSE #

General Provider Information

NPI Number : 1245524370
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JASON BRIAN WASSERMAN M.D.
Provider Business Mailing Address
First Line : 660 WHITE PLAINS RD FL 4
Second Line :
City : TARRYTOWN
State : NY
Zip : 10591-5139
Country : US
Telephone Number : 914-984-2546
Fax Number :
Provider Business Practice Location Address
First Line : 3526 FRANCIS LEWIS BLVD
Second Line :
City : FLUSHING
State : NY
Zip : 11358-1954
Country : US
Telephone Number : 718-631-8899
Fax Number : 718-631-4401
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2011
Last Update Date : 07/31/2024

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Directions to “ DR. JASON BRIAN WASSERMAN M.D.” Practice Location

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